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MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. -- Part one of this three-part series described the What of evidence-based practice. This article will focus more on Why EBP is so important to Madigan Army Medical Center, and the military healthcare system.

To ask the question "Why?" is a great place to start with EBP. As you go throughout your day providing patient care, do you ever wonder why things are done a certain way? Simply doing something because "that is the way we've always done things" sets us up for failure. EBP can assist us as we embrace a culture of inquiry and look towards the literature to determine the evidence that supports our practice.

Healthcare is continually evolving as advances are made in research and technology. We owe it to our patients and staff to ensure our practice is based on reliable research and that it continues to evolve as new research demonstrates the need to change practice. As newer, better methods for delivering care are established, it is important to bring these improvements to our patients. Madigan is on a journey toward becoming a high-reliability organization. The goals of an HRO are improved quality and safety involving healthcare delivery. Implementing EBP supports these objectives.

Using EBP supports the MHS Quadruple Aim

The MHS "Quadruple Aim" goals include better health, better care, lower costs and improved readiness, which nest within the HRO goals. By implementing EBP, we are demonstrating that we are committed to providing the best care available, resulting in the best outcomes for our patients.

In addition to addressing why we use EBP, it also makes sense to address "why not?" Often when people aren't implementing EBP, it is due to a knowledge gap; in order to close this gap it is important to stay current on recent literature and professional guidelines.

One example of EBP implementation at Madigan involved patients who are required to be on ventilators. Infection preventionists noticed ventilator-associated events or infections that could be prevented. A literature search identified the use of a nasal swab to clean out the nostrils, which can act as reservoirs for microorganisms. These microorganisms have the potential to migrate and cause infection, especially on ventilated patients. After implementing these nasal swabs, ventilator-associated event rates have dropped to zero.

This is just one example, but EBP is happening all around our organization.

We don't always have time to read the latest research studies, but other resources are available. At conferences and other education opportunities, EBP is often what is presented. At Madigan, there are clinical nurse specialists positioned throughout the hospital who are bringing EBP to the bedside. They can also help coach and mentor others who would like to start an EBP initiative.

Next time you conduct patient care, ask yourself why you are doing it that way. Discover if your practices are supported by current EBP recommendations. Why do we need EBP? In short, to provide the best possible care we can.

Stay tuned for Part 3 of this series… "Evidence-Based How?"

To read Part 1 -- the What, visit https://www.army.mil/article/230495/

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